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Comparison of the Montreal Cognitive Assessment and the Mini-Mental State Examination in detecting multi-domain mild cognitive impairment in a Chinese sub-sample drawn from a population-based study

Published online by Cambridge University Press:  22 July 2013

YanHong Dong
Affiliation:
Department of Pharmacology, National University of Singapore, Singapore Memory Aging and Cognition Centre, National University Health System, Singapore School of Psychiatry, University of New South Wales, Australia
Wah Yean Lee
Affiliation:
Department of Pharmacology, National University of Singapore, Singapore Memory Aging and Cognition Centre, National University Health System, Singapore
Saima Hilal
Affiliation:
Department of Pharmacology, National University of Singapore, Singapore Memory Aging and Cognition Centre, National University Health System, Singapore
Monica Saini
Affiliation:
Memory Aging and Cognition Centre, National University Health System, Singapore
Tien Yin Wong
Affiliation:
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
Christopher Li-Hsian Chen*
Affiliation:
Department of Pharmacology, National University of Singapore, Singapore Memory Aging and Cognition Centre, National University Health System, Singapore
Narayanaswamy Venketasubramanian
Affiliation:
Memory Aging and Cognition Centre, National University Health System, Singapore Department of Medicine, National University Health System, Singapore Neuroscience Clinic, Raffles Hospital, Singapore
Mohammad Kamran Ikram
Affiliation:
Memory Aging and Cognition Centre, National University Health System, Singapore Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
*
Correspondence should be addressed to: Dr Christopher Li-Hsian Chen, Department of Pharmacology, National University Health System, Clinical Research Centre, MD11, Level 5, #05-9, 10 Medical Drive, Singapore117597. Phone: +65-65165885; Fax: +65-68724101. Email: phccclh@nus.edu.sg.

Abstract

Background:

We examined the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting multiple-domain mild cognitive impairment (md-MCI) in a Chinese sub-sample drawn from elderly population-based study.

Methods:

This study included Chinese participants from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 years who underwent cognitive screening with the Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Screen-positive participants subsequently underwent MoCA, MMSE, and a comprehensive formal neuropsychological battery. MCI was defined by Petersen's criteria and further classified into single-domain MCI (sd-MCI) and md-MCI. Area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs) was computed for the MoCA and the MMSE in detecting md-MCI.

Results:

A total of 300 participants were recruited: 128 (42.7%) were diagnosed with no cognitive impairment (NCI), 47 (15.7%) with sd-MCI, and 83 (28.0%) with md-MCI. Forty-one participants were excluded, 7 (2.3%) had dementia, and 34 (11.3%) had only objective cognitive impairment without subjective complaints. Although the MoCA had a significantly larger AUC than the MMSE (0.94 (95% CI = 0.91–0.97) vs. 0.91 (95% CI = 0.86–0.95), p= 0.04), at optimal cut-off points, the MoCA (19/20) was equivalent to the MMSE (25/26) in detecting md-MCI (sensitivity: 0.80 vs. 0.87, specificity: 0.92 vs. 0.80).

Conclusion:

Both screening tests had good discriminant validity and can be used in detecting md-MCI in a sub-sample of Chinese drawn from a population-based study.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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